Exploring emotions and cognitions in hoarding: a Q-methodology analysis

Background: The cognitions and emotions of people prone to hoarding are key components of the dominant cognitive behavioural model of hoarding disorder. Aims: This study sought to use Q-methodology to explore the thoughts and feelings of people that are prone to hoarding, to identify whether distinct clusters of participants could be found. Method: A 49-statement Q-set was generated following thematic analysis of initial interviews (n= 2) and a review of relevant measures and literature. Forty-one participants with problematic hoarding met various study inclusion criteria and completed the Q-sort (either online or offline). A by-person factor analysis was conducted and subsequent participant clusters compared on psychometric measures of mood, anxiety, hoarding and time taken on the online task as proxy for impulsivity. Results: Four distinct participant clusters were found constituting 34/41 (82.92%) of the participants, as the Q-sorts ofn= 7 participants failed to cluster. The four clusters found were 'overwhelmed' (n= 11 participants); 'aware of consequences' (n= 13 participants); 'object complexity' (n= 6 participants) and 'object-affect fusion' (n= 4 participants). The clusters did not markedly differ with regard to hoarding severity, anxiety, depression or impulsivity. Conclusions: Whilst the participant clusters reflect extant research evidence, they also reveal significant heterogeneity and so prompt the need for further research investigating emotional and cognitive differences between people prone to hoarding.